Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,510.77 / $3,429.45 / $3,580.52	Facility		$1,510.77	$3,429.45	$3,580.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,127.81 / $1,510.77 / $3,580.52	Professional		$1,127.81	$1,510.77	$3,580.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,960.27 / $4,845.71 / $10,889.05	Facility		$1,960.27	$4,845.71	$10,889.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,606.99 / $1,947.65 / $14,954.09	Professional		$1,606.99	$1,947.65	$14,954.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,544.16 / $1,544.16 / $1,544.16	Facility		$1,544.16	$1,544.16	$1,544.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,127.24 / $1,127.24 / $1,544.16	Professional		$1,127.24	$1,127.24	$1,544.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,267.17 / $2,238.67 / $5,766.56	Facility		$1,267.17	$2,238.67	$5,766.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,268.56 / $2,238.67 / $4,273.21	Professional		$1,268.56	$2,238.67	$4,273.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,544.57 / $1,716.19 / $1,887.80	Professional		$1,544.57	$1,716.19	$1,887.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,777.01 / $2,014.81 / $2,238.67	Facility		$1,777.01	$2,014.81	$2,238.67
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,013.95 / $2,238.67 / $2,238.67	Professional		$2,013.95	$2,238.67	$2,238.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,960.27 / $2,514.14 / $4,372.42	Facility		$1,960.27	$2,514.14	$4,372.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,130.81 / $2,186.21 / $2,186.21	Facility		$2,130.81	$2,186.21	$2,186.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,778.44 / $1,902.88 / $2,462.55	Professional		$1,778.44	$1,902.88	$2,462.55
United Facility/Professional Professional Modifier Low / Median / High Price $928.96 / $1,004.74 / $1,916.90	Professional		$928.96	$1,004.74	$1,916.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $598.47 / $598.47 / $1,226.58	Professional		$598.47	$598.47	$1,226.58